Individual
JORDAN LOUISE KOONTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
214 COLLEGE PARK PLZ, JOHNSTOWN, PA 15904-2833
(888) 918-5465
Mailing address
432 DUNKARD HOLLOW RD, ALUM BANK, PA 15521-7706
(814) 979-8146
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
06/11/2018
Last updated
11/01/2019
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